Healthcare Provider Details

I. General information

NPI: 1386709269
Provider Name (Legal Business Name): CLARESE BEATRICE ZAHL L.M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARESE BEATRICE HENDERSON LMP

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 ALASKAN WAY S SUITE 105A
SEATTLE WA
98104
US

IV. Provider business mailing address

PO BOX 4034
SEATTLE WA
98194-0034
US

V. Phone/Fax

Practice location:
  • Phone: 206-618-5114
  • Fax: 206-577-3803
Mailing address:
  • Phone: 206-618-5114
  • Fax: 206-577-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA00010972
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00010972
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: